1. Field of the Invention
This invention has relation to an apparatus and method for increasing compliance with prescribed regimes of medication by mature patients.
A general text of geriatric medicine (Libow LS, Sherman FT: The Core of Geriatric Medicine: A Guide for Student and Practitioners, published in St. Louis in 1981 by CV Mosby Co., at Page 107) notes that between 30% and 50% of all patients fail to comply with their physicians' prescriptions. Interviews conducted with 178 elderly outpatients revealed that 59% are making errors in their medications and about 1/4 of the group as a whole averaged as many as 2.3 potentially serious errors per patient (Schwartz D, Wang M, Zeitz L. et al: Medication Errors Made by Elderly, Chronically Ill Patients, published in the American Journal of Public Health 52:2018-29, 1962).
A study examining non-compliance in patients recently discharged from an acute care facility found that 50% of the patients deviated from the prescribed regime (Parkin DM, Henney CR, Quirk J, et al: Deviation from Prescribed Drug Treatment After Discharge from Hospital, published in the British Medical Journal 2:686, 1976).
Medication errors are an important factor in producing illness. Up to 5% of patients may have a drug-induced illness upon admission to the hospital, according to Seidl, LG, Thomtom GF, Smith JW, et al: Studies On the Epidemiology of Adverse Drug Reactions, published in The Bulletin of Hopkins Hospital at 119:299-315, 1966. A high percentage of the patients having such drug-induced illness may not be due to the inherent toxitity of the drug, but rather to its improper use. (Stewart RB, Cluff, LE: A Review of Medication Errors in Compliance with Ambulant Patients, published in Clinical Pharmacy and Therapy, 13(4):463-468, 1972).
As a group, the elderly are the greatest consumers of prescription and non-prescription medicines. Persons over age 65 constitute 11% of the population, but account for more than 25% of drug expenditures (Gibson RM, Mueller MS, Fisher CR: Age Differences in Health Care Spending, Fiscal Year 1976, published in Social Security Bulletin 40-3-4, 1977).
The factors which play a role in this poor patient compliance include poor patient motivation, failure to develop a trusting relationship with the physician, memory loss and other cognitive dysfunctions, attenuation of the special senses, and a lack of sufficient knowledge on the part of the patient. Factors such as congnitive dysfunction, poor eyesight, and lack of patient education may be overcome with memory devices and improved instruction. Because the geriatric patient is prone to these problems, the geriatric population is a logical target group to test compliance-improving strategies.
2. Description of the Prior Art
The apparatus and method of the present invention were developed in order to overcome the problem of non-compliance with physicians' prescriptions, and the invention was then tested against other strategies and were simultaneously compared to a control group. These strategies included standardized instructions with tapes and transcripts; color-coded pill bottles; and color-coded pill bottles matched to a color-coded weekly pill tray in accordance with the invention. The group using the apparatus and method of the present invention did significantly better than the control group while the group employing the other two strategies did not.
Specifically, the control group deviated an average of 17.1% from the ideal pill counts made at the end of the tests; the group receiving standardized instruction deviated 14.1%; the group using color-coded pill bottles alone deviated by 17.3%; and the group using the apparatus and method of the present invention deviated by an average of only 1.7%.
It is known to provide filled dispensers which include 28 separate pill-receiving compartments, and it is known to provide covers for such dispensers whereby the compartments can be accessed one at a time; but the accuracy in adhering to the prescribed regime by accessing the proper compartment at the proper time can be no greater than the accuracy in loading the pills into the individual compartments. See the following U.S. patents: U.S. Pat. No. 3,921,806, granted to Wawracz in November of 1975; U.S. Pat. No. 3,225,913, granted to Lee in December of 1965; U.S. Pat. No. 3,530,818, granted to Secondino in September of 1970; U.S. Pat. No. 3,537,422, granted to Moe in November of 1970; U.S. Pat. No. 4,039,080, granted to Cappuccilli in August of 1977; U.S. Pat. No. 3,738,480, granted to Chesley in June of 1973; U.S. Pat. No. 3,618,559, granted to Joe in November of 1971.
The foregoing patents were located in a search made of the present invention. Also located in the search was U.S. Pat. No. 3,996,879 granted to Walton in December of 1976. It discloses a reminder device having a band which fits around a pill container and is not believed to be pertinent to the invention.
A system for handling and dispensing pre-packaged unit doses of medicine for a large number of patients is disclosed in U.S. Pat. No. 3,826,222, granted to Romick in July of 1974. The system is designed for use in hospitals; and is not believed to be applicable for adaptation for use by patients themselves in prepackaging, storing and dispensing complicated regimes of medication at several times a day over a period of a week.
A peg board adapted for use by persons required to take one or more doses of a plurality of medicine over a span of hours and days is presented in U.S. Pat. No. 4,148,273 granted to Hollingsworth et al in April of 1979. The device of this invention would be of little or no value to a geriatric patient attempting to handle his own medication. Certainly the concept of the present invention is not shown or suggested in the Hollingsworth patent.
Applicant and those in privity with him are aware of no prior art closer than that cited and discussed above; and are aware of no prior art which anticipates the claims herein.